The Centers for Disease Control and Prevention (CDC) invoked its authority
under federal law last week to hold an unnamed Atlanta man in isolation in New
York City and later an Atlanta hospital. The patient was reportedly contacted by
CDC while traveling in Europe and informed that unrelated medical tests had
indicated that he had a dangerous, drug-resistant form of tuberculosis.

The threat of communicable disease, including the threat of bio-terrorism or
the emergence of a new microbe, is of serious concern to all of us. No one
disputes that the government is responsible for responding to threats that could
have serious and deadly consequences, and that powers of quarantine and
isolation are a legitimate part of the government’s authority where it is
justified by a the presence of a genuinely communicable and life-threatening
disease.

However, the power to forcibly detain and confine a person is an
extraordinary power and, like all government powers in a civilized democracy,
can never go unchecked. Public health authorities make mistakes, and politicians
abuse their powers. For example, there is a history of discriminatory use of the
quarantine power against particular groups of people based on race and national
origin.

Quarantine and isolation must be last resorts that are employed only after
less restrictive alternatives have been employed and failed, or are impossible
to use under the circumstances. In the vast majority of cases, sick individuals
are the first to want proper medical attention and need no encouragement or
state coercion to voluntarily isolate themselves.

In the current case of the Atlanta man, the ACLU has no information
indicating that the government has done anything to violate the patient’s
rights. However, it is important that the man have access to due process and a
right to appeal his condition.

Due process rights are particularly important as modern medicine advances,
and diagnoses of illnesses are increasingly made based on advanced technological
tests, where the individual may have no symptoms, and the threat that disease
will be spread may be unknown, ambiguous, or in dispute - or may even be the
result of a laboratory error.

A right to redress is also important because of the looming threat of
bio-terrorism or a naturally occurring epidemic such as avian flu, which might
create a genuine public emergency and/or spark a widespread public panic. In the
face of such possibilities, it is all the more important that the government set
good precedents and ‘get it right’ with respect to individual cases such as
this.

In recent years, the CDC proposed new regulations for the quarantine of
travelers, and advanced model emergency health powers legislation at the state
level. The ACLU raised serious concerns about these proposals. The current case
appears to demonstrate that, whatever the shortcomings of our public health
laws; a lack of authority to respond in cases where it believes a threat exists
is not one of them.